This Article Free upon publication Full Text Full Text (PDF) All Versions of this Article: 51/4/1047    most recent HYPERTENSIONAHA.107.106062v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Macedo, M. L. Articles by Nicolaides, K. H. Search for Related Content PubMed PubMed Citation Articles by Macedo, M. L. Articles by Nicolaides, K. H. Related Collections Other hypertension Other Vascular biology Other Research

(Hypertension. 2008;51:1047.)
© 2008 American Heart Association, Inc.

Go Red Original Articles

Maternal Wave Reflections and Arterial Stiffness in Normal Pregnancy as Assessed by Applanation Tonometry

Maria L. Macedo; Daniele Luminoso; Makrina D. Savvidou; Carmel M. McEniery; Kypros H. Nicolaides

From the Harris Birthright Research Centre for Fetal Medicine (M.L.M., D.L., M.D.S., K.H.N.), King’s College Hospital, London, UK; and the Clinical Pharmacology Unit (C.M.M.), University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK.

Correspondence to Dr M.D. Savvidou, Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, Denmark Hill, London SE5 8RS, UK. E-mail msavvidou{at}dsla.ndo.co.uk

Normal pregnancy is associated with profound alterations in the maternal cardiovascular system. The aim of the present study was to assess noninvasively, using applanation tonometry, the maternal central aortic blood pressures (BP), effects of wave reflection and arterial stiffness (aortic and brachial pulse wave velocity) in normal pregnancy. This was a cross sectional study including 193 women with normal singleton pregnancies at 11 to 41 weeks of gestation and 23 nonpregnant controls, matched for age and height. Compared to nonpregnant controls, pregnant women had lower mean arterial pressure (85±8.9 mm Hg versus 81.1±7.2 mm Hg; P=0.01), central systolic BP (103±11 mm Hg versus 96±8 mm Hg, P=0.001), central diastolic BP (71±9 mm Hg versus 67±7 mm Hg, P=0.008), and augmentation index (AIx) (19±11% versus 4±12%, P<0.001). The AIx changed significantly with gestation reaching its nadir at midpregnancy (R²=0.05, P=0.007). This change was present even after adjusting for maternal age (P<0.001), heart rate (P<0.001), and mean arterial BP (P<0.001); known determinants of AIx. The pulse wave velocity (carotid-radial and carotid-femoral) did not change significantly with gestation and was marginally different between pregnant and nonpregnant women (P=0.03 and P=0.05 for carotid-radial and carotid-femoral respectively). However, adjustments for maternal age and mean arterial pressure rendered these differences nonsignificant (P=0.2 for carotid-radial, P=0.5 for carotid-femoral). In summary, we found that normal pregnancy is associated with a reduction in central BP and wave reflection.

Key Words: pregnancy • applanation tonometry • arterial stiffness • augmentation index • pulse wave velocity

This article has been cited by other articles:

				A. O. Robb, N. L. Mills, J. N. Din, I. B.J. Smith, F. Paterson, D. E. Newby, and F. C. Denison Influence of the Menstrual Cycle, Pregnancy, and Preeclampsia on Arterial Stiffness Hypertension, June 1, 2009; 53(6): 952 - 958. [Abstract] [Full Text] [PDF]